[The pathophysiological and intensive care-resuscitation aspects of septic shock]

Sepsis and septic shock continue to be the most common causes of death and multiple organ failure among patients in intensive care units. The standard therapeutic regimens include surgical removal of the source of sepsis, antimicrobial therapy, optimizing oxygenation, volume resuscitation, and treatment with catecholamines. The ever extending knowledge of the pathophysiological role played by cytokines and nitrous oxide in septic shock promote the efforts to control their synthesis and pharmacologic action in clinical situations. New therapeutic approaches have become available, including the administration of high doses immunoglobulins, monoclonal antibodies against endotoxin, pentoxilfyline and nitrous oxide inhibitors. Based on the encouraging findings, controlled clinical studies are undertaken to assay with precision their clinical efficacy.